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alspac_12weeks
ABOUT YOURSELF
This questionnaire asks about your health, your partner, your home, your childhood and your beliefs and attitudes. Your answers will help us to understand how mothers' own health and background might affect their pregnancies.
All the answers you give are confidential. Your name and address will not be on the questionnaire.
We would be grateful if you would help us by answering as many of these questions as possible but if there is any question you do not want to answer that is fine. Just leave it blank.
THANK YOU VERY MUCH FOR YOUR HELP
SECTION A: YOUR MEDICAL HISTORY
A1 a

How old were you when your periods first started?

Age
77
have not had periods
99
do not remember
A1 b

In the year before your study pregnancy would you say your periods were regular?

1
yes
2
no, not very regular
7
no periods at all
If regular,
qc_A1_b == 1
A1 c

how many days were there from the start of one period to the start of the next one ? ... days

Days
A2 a

Have you ever used a contraceptive pill?

1
Yes
2
No
If no, go to A3.a, on page 4.
If yes,
qc_A2_a == 1
A2 b

how old were you when you first used one? ... years

Age
A2 c

how many years altogether did you take a contraceptive pill?

1
under 1 year
2
1-2 years
3
3-4 years
4
5 years or more
A2 d

Is it possible that you might have taken the pill when you were actually pregnant this last time?

1
Yes
2
No
A3 a

Have you ever gone to a doctor because you thought you were infertile?

1
Yes
2
No
If no, go to A4.a
If yes,
qc_A3_a == 1
A3 b

what treatment was given?

Generic text
A3 c(i)

Did you use any treatments to help you conceive this last pregnancy?

1
Yes
2
No
If yes,
qc_A3_c_i == 1
A3 c(ii)

which one?

Generic text
A4 a

What was your weight before you started this last pregnancy? (please indicate whether stones, pounds or kilos)

Generic text
A4 b

Are you certain of your weight before you started this pregnancy?

1
Yes
2
No
A4 c(i)

Before you became pregnant this last time, what was your size in:- hips ... ins.

Inches
A4 c(ii)

Before you became pregnant this last time, what was your size in:- waist ... ins.

Inches
A4 c(iii)

Before you became pregnant this last time, what was your size in:- bust ... ins.

Inches
(if you don't know write NK)
A4 d

How tall are you ? (Please indicate whether feet, inches or metres)

Generic text
A4 d(i)

Are you certain of this?

1
Yes
2
No
A5 a

Have you ever had diabetes?

1
Yes
2
No
If No, go to A5.b, on page 6.
If yes,
qc_A5_a == 1
A5 a(i)

have you only had it when you were pregnant?

1
Yes
2
No
A5 a(ii)

how is/was it treated?

1
insulin injections
2
other drugs
3
diet only
A5 a(iii)

how old were you when you first developed it? ... years

Age
A5 b

Have you ever had hypertension (high blood pressure)?

1
Yes
2
No
If yes,
qc_A5_b == 1
A5 b(i)

Have you had it only when pregnant?

1
Yes
2
No
A5 b(ii)

How old were you when you first developed it? ... years

Age
A5 b(iii)

How is it treated?

Generic text
A6 a

Have you ever had any of the following infections: measles

1
Yes
2
No never
9
Don't know
A6 b

Have you ever had any of the following infections: mumps

1
Yes
2
No never
9
Don't know
A6 c

Have you ever had any of the following infections: chicken pox

1
Yes
2
No never
9
Don't know
A6 d

Have you ever had any of the following infections: whooping cough

1
Yes
2
No never
9
Don't know
A6 e

Have you ever had any of the following infections: cold sores

1
Yes
2
No never
9
Don't know
A6 f

Have you ever had any of the following infections: meningitis

1
Yes
2
No never
9
Don't know
A6 g

Have you ever had any of the following infections: genital herpes

1
Yes
2
No never
9
Don't know
A6 h

Have you ever had any of the following infections: syphilis

1
Yes
2
No never
9
Don't know
A6 i

Have you ever had any of the following infections: gonorrhea

1
Yes
2
No never
9
Don't know
A6 j

Have you ever had any of the following infections: urinary infection, cystitis, pyelitis

1
Yes
2
No never
9
Don't know
A7 a

Have you ever had any of the following operations: tonsils out

1
Yes
2
No
A7 b

Have you ever had any of the following operations: adenoids out

1
Yes
2
No
A7 c

Have you ever had any of the following operations: hernia repair

1
Yes
2
No
A7 d

Have you ever had any of the following operations: appendix out

1
Yes
2
No
A7 e

Have you ever had any of the following operations: gall bladder out

1
Yes
2
No
A7 f

Have you ever had any of the following operations: D and C (a scrape)

1
Yes
2
No
A7 g

Have you ever had any of the following operations: pyloric stenosis operation

1
Yes
2
No
A7 h

Have you ever had any of the following operations: squint repaired

1
Yes
2
No
A7 i

Have you ever had any of the following operations: plastic surgery

1
Yes
2
No
A7 j

Have you ever had any of the following operations: grommets in your ears

1
Yes
2
No
A7 k

Have you ever had any of the following operations: other type of operation (please tick and describe)

1
Yes
2
No
Other
A8 a-q
Have any of the following ever happened?

(tick one in each row, and add age if you had such an incident)

- Age this first happened

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age
You were badly burnt
You were badly scalded
You took a lot of pills or medicine
You broke an arm or hand
You broke a leg or foot
You nearly drowned
You were in a road traffic accident
You were sexually assaulted
You were injured playing sports or games
You had an accident while on a bicycle
You were injured in a fight
Your parents hurt you
You were hurt by someone else
Your head was hit
You were badly cut
You had a bad fall
You had another type of accident or injury (please describe)
A8 q

Have any of the following ever happened? You had another type of accident or injury (please describe)

Other
A9 a

Have you ever had any of the following problems: hay fever

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 b

Have you ever had any of the following problems: indigestion

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 c

Have you ever had any of the following problems: bulimia

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 d

Have you ever had any of the following problems: asthma

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 e

Have you ever had any of the following problems: eczema

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 f

Have you ever had any of the following problems: epilepsy

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 g

Have you ever had any of the following problems: convulsions with a fever

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 h

Have you ever had any of the following problems: migraine

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 i

Have you ever had any of the following problems: back pain/slipped disc

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 j

Have you ever had any of the following problems: kidney disease

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 k

Have you ever had any of the following problems: varicose veins

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 l

Have you ever had any of the following problems: haemorrhoids/piles

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 m

Have you ever had any of the following problems: rheumatism

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 n

Have you ever had any of the following problems: arthritis

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 o

Have you ever had any of the following problems: psoriasis

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 p

Have you ever had any of the following problems: stomach ulcer

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 q

Have you ever had any of the following problems: pelvic inflammatory disease (PID)

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 r

Have you ever had any of the following problems: drug addiction

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 s

Have you ever had any of the following problems: alcoholism

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 t

Have you ever had any of the following problems: schizophrenia

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 u

Have you ever had any of the following problems: anorexia nervosa

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 v

Have you ever had any of the following problems: severe depression

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 w

Have you ever had any of the following problems: other psychiatric problem

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 x

Have you ever had any of the following problems: other problem (please tick & describe)

1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
Other
A10 a

Are there any problems for which you have regular treatment or medicine?

1
Yes
2
No
If No, go to A11, on page 11.
If yes,
qc_A10_a == 1
A10 b
please describe the problem and regular treatment or medicine:
Problem Treatment or medicine
Generic textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric text
1
2
3
4
A11 a

Would you say that you were allergic to anything?

1
Yes
2
No
If No, go to A12.
If yes,
qc_A11_a == 1
A11 b(i-v)
is it to:
-

1 - Yes

2 - No

9 - Don't know
cat
pollen
dust
insect bites or stings
A11 b(v)

is it to: something else (please describe)

1
Yes
2
No
9
Don't know
Other
A12 a-i
Have you had any of the following in the past two years:
-

1 - Yes, often

2 - Yes, sometimes

3 - No, not at all
attacks of wheezing with whistling on the chest
a dry itchy rash
a blotchy blistery rash (hives)
sneezing attacks
runny nose
watery eyes
attacks of breathlessness
cough often during the night
cough often when you wake in the morning
A13 a

Do you know how much you weighed when you were born?

1
Yes
2
No
If yes,
qc_A13_a == 1
A13 aa

give weight:

Generic text
A13 b

Were you born:

1
more than 3 weeks before your expected date
2
at around the date expected
3
more than 3 weeks late
9
don't know
A13 c(i)

Were you born with any of the following: hare lip

1
Yes
2
No
A13 c(ii)

Were you born with any of the following: birthmark

1
Yes
2
No
A13 c(iii)

Were you born with any of the following: cleft palate

1
Yes
2
No
A13 c(iv)

Were you born with any of the following: heart disease

1
Yes
2
No
A13 c(v)

Were you born with any of the following: malformed feet

1
Yes
2
No
A13 c(vi)

Were you born with any of the following: unusual shaped head

1
Yes
2
No
A13 c(vii)

Were you born with any of the following: spina bifida

1
Yes
2
No
A13 c(viii)

Were you born with any of the following: extra finger

1
Yes
2
No
A13 c(ix)

Were you born with any of the following: extra toe

1
Yes
2
No
A13 c(x)

Were you born with any of the following: funny shaped fingers or hands

1
Yes
2
No
A13 c(xi)

Were you born with any of the following: missing part of body

1
Yes
2
No
A13 c(xii)

Were you born with any of the following: other (please describe all such problems below)

1
Yes
2
No
Other
A13 d(i)

Were you born in a hospital?

1
Yes
2
No
9
Don't know
If yes, please give:
qc_A13_d_i == 1
A13 d(ii)

Name of hospital

Generic text
A13 e(i)

Where were your parents living at the time you were born? Town:

Generic text
A13 e(ii)

Where were your parents living at the time you were born? County:

Generic text
A13 e(iii)

Where were your parents living at the time you were born? Country:

Generic text
Your hearing
A14 a(i)

How would you rate your hearing in each ear? Left ear

1
always very good
2
occasional problems (eg.infections or glue ear)
3
there are some sounds I can not hear
4
never very good
5
I cannot hear much at all
A14 a(ii)

How would you rate your hearing in each ear? Right ear

1
always very good
2
occasional problems (eg.infections or glue ear)
3
there are some sounds I can not hear
4
never very good
5
I cannot hear much at all
Your eyesight
A15 a(i)

How would you rate your sight without glasses? Left eye

1
always very good
2
I can't see clearly at a distance
3
I can't see clearly close up
4
I can't see much at all
A15 a(ii)

How would you rate your sight without glasses? Right eye

1
always very good
2
I can't see clearly at a distance
3
I can't see clearly close up
4
I can't see much at all
A15 b

Are you colour blind?

1
Yes
2
No
9
Don't know
A16 a

When you were a child did you ever go to any of the following? physiotherapist

1
Yes
2
No
9
Not known
If yes,
qc_A16_a == 1
A16 a(i)

what for:

Generic text
A16 b

When you were a child did you ever go to any of the following? child guidance or child psychiatrist

1
Yes
2
No
9
Not known
If yes,
qc_A16_b == 1
A16 b(i)

what for:

Generic text
A16 c

When you were a child did you ever go to any of the following? speech therapist

1
Yes
2
No
9
Not known
If yes,
qc_A16_c == 1
A16 c(i)

what for:

Generic text
A16 d

When you were a child did you ever go to any of the following? special schooling

1
Yes
2
No
9
Not known
If yes,
qc_A16_d == 1
A16 d(i)

what for:

Generic text
A17 a-d
Did you or any of your family have a problem of bedwetting or daytime wetting? (when older than 5 years)
-

1 - Yes, bed-wetting

2 - Yes, daytime wetting

4 - No, not at all

9 - Don't know
you
brother or sister
mother
father
A18 a

Have you had a wetting accident yourself in the past year, either during the night or day?

1
Yes
2
No
If yes,
qc_A18_a == 1
A18 b(i)

Could you please indicate how many nights or days this has occurred within the past month: during the night:

Days in month
A18 b(ii)

Could you please indicate how many nights or days this has occurred within the past month: during the day:

Days in month
A19 a

Have you ever been a blood donor?

1
Yes
2
No
A19 b

If you were found to have a rare blood type during this pregnancy would you be willing to give blood?

1
Yes
2
No
A20 a-l
Many people have X-rays, barium meals and other procedures. Please indicate whether you have ever had any of the following types of X-ray.
During this last pregnancy In the year before this last pregnancy Any other time during your life

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No
X-ray to: arm or hand
X-ray to: chest
X-ray to: leg or foot
X-ray to: dental
X-ray to: head or neck
X-ray to: back
X-ray to: barium meal
X-ray to: barium enema
X-ray to: IVP (intravenous pyelogram}
X-ray to: hips or pelvis
X-ray to: stomach or abdomen
X-ray to: any other (please describe)
A20 l

Many people have X-rays, barium meals and other procedures.Please indicate whether you have ever had any of the following types of X-ray. any other (please describe)

Other
SECTION B: YOUR PARTNER
The following questions are about how you and your partner behave towards each other. Please indicate how often you and your partner behave in the ways listed.
* If you do not have a partner at the moment tick 'Not applicable'.
B1

Is your partner affectionate toward you?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B2

Does your partner get angry with you?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B3

Does your partner listen to you when you want to talk about your feelings?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B4

Do you have arguments with your partner?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B5

Does your partner talk to you about his problems and feelings?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B6

Do you get angry with your partner?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B7

Do you enjoy the company of your partner?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B8

Does your partner show his approval of you?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B9

Do you behave affectionately toward your partner?

1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B10

How old is your partner? ... years

Age
SECTION C: YOU AND YOUR PARENTS
C1 a

Were you legally adopted?

1
Yes
2
No
If yes,
qc_C1_a == 1
C1 b

what age were you?

Generic text
C2

Were you ever "in care" of either a local authority or voluntary agency e.g. Barnados?

1
Yes
2
No
9
Unsure
C3 a

Did your parents divorce or separate before your 18th birthday?

1
Yes
2
No
If No, go to C4, on page 19.
If yes,
qc_C3_a == 1
C3 b

what age were you?

Generic text
C3 c

who did you mainly live with after this?

1
mother
2
father
3
sometimes mother, sometimes father
4
someone else (please say who)
Other
C4 i-iv
Did you ever live away from home with any of the following (other than for holidays/or short visits) before you were 18 years old?
-

1 - Yes

2 - No
grandparents
other relatives
friends
foster parents
C4 v

Did you ever live away from home with any of the following (other than for holidays/or short visits) before you were 18 years old? other (please describe)

1
Yes
2
No
Other
C5 i-v
Did you ever stay away from home in any of the following places before you were 18 years old?
-

1 - No

2 - Yes for less than a week

3 - Yes for 1 week - 1 month

4 - Yes for 1 - 6 months

5 - Yes over 6 months
hospital
boarding school
children's home
hostel
in custody (detention centre, remand home, borstal etc)
C5 vi

Did you ever stay away from home in any of the following places before you were 18 years old? other please describe)

1
No
2
Yes for less than a week
3
Yes for 1 week - 1 month
4
Yes for 1 - 6 months
5
Yes over 6 months
Other
C6 a

Did you leave home before your 18th birthday?

1
Yes
2
No
If no, go to C7, on page 20.
If yes,
qc_C6_a == 1
C6 b

At that time where did you first live?

1
college residence
2
hostel
3
bedsit
4
shared flat or house
5
other (please describe)
Other
C7 a-n
At each of the time periods given, during your childhood, who of the following lived in your home (other than for holidays or short visits)?
0-5 years 6-11 years 12-16 years

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No
mother
father
brother(s)
sister(s)
step-mother
step-father
step-brother(s)
step-sister(s)
mother's partner
father's partner
grandmother
grandfather
family friend
other (please describe)
C7 n

At each of the time periods given, during your childhood, who of the following lived in your home (other than for holidays or short visits)? other (please describe)

Other
C8 a

Who would you say brought you up? mother

1
Yes
2
No
3
Did not have
C8 b

Who would you say brought you up? father

1
Yes
2
No
3
Did not have
C8 c

Who would you say brought you up? brother(s)

1
Yes
2
No
3
Did not have
C8 d

Who would you say brought you up? sister(s)

1
Yes
2
No
3
Did not have
C8 e

Who would you say brought you up? step-mother

1
Yes
2
No
3
Did not have
C8 f

Who would you say brought you up? step-father

1
Yes
2
No
3
Did not have
C8 g

Who would you say brought you up? step-brother(s)

1
Yes
2
No
3
Did not have
C8 h

Who would you say brought you up? step-sister(s)

1
Yes
2
No
3
Did not have
C8 i

Who would you say brought you up? mother's partner

1
Yes
2
No
3
Did not have
C8 j

Who would you say brought you up? father's partner

1
Yes
2
No
3
Did not have
C8 k

Who would you say brought you up? grandmother

1
Yes
2
No
3
Did not have
C8 l

Who would you say brought you up? grandfather

1
Yes
2
No
3
Did not have
C8 m

Who would you say brought you up? adoptive mother

1
Yes
2
No
3
Did not have
C8 n

Who would you say brought you up? adoptive father

1
Yes
2
No
3
Did not have
C8 o

Who would you say brought you up? foster mother

1
Yes
2
No
3
Did not have
C8 p

Who would you say brought you up? foster father

1
Yes
2
No
3
Did not have
C8 q

Who would you say brought you up? family friend

1
Yes
2
No
3
Did not have
C8 r

Who would you say brought you up? other (please describe)

1
Yes
2
No
3
Did not have
Other
C9 a-o
Has your natural mother and/or mother figure had any of the following:

(If you only had a natural mother, answer only under 'natural mother')

Natural mother Mother figure

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know
diabetes treated with insulin
other diabetes
coronary heart disease
rheumatism
arthritis
multiple sclerosis
breast cancer
other cancer
hypertension (high blood pressure)
an alcohol problem
schizophrenia
chronic bronchitis
a stroke
depression or 'nerves'
other problem (please describe)
C9 o

Has your natural mother and/or mother figure had any of the following: other problem (please describe)

(If you only had a natural mother, answer only under 'natural mother')

Other
C10 a

Would you say that your mother (or mother figure) was disabled in any way?

1
Yes
2
No
If yes,
qc_C10_a == 1
C10 b

please describe:

Generic text
C11 a

Would you say that any problems in your mother's (or mother figure's) physical or mental health affected you in any way?

4
she had no problems
1
yes, major effect
2
yes, minor effect
3
she had some problems, but they did not affect my upbringing
If yes,
qc_C11_a == 1 || qc_C11_a == 2
C11 b

please describe:

Generic text
C12 a-o
Has your natural father and/or father figure had any of the following:

(If you only had a natural father, answer only under 'natural father')

Natural father Father figure

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know
diabetes treated with insulin
other diabetes
coronary heart disease
rheumatism
arthritis
multiple sclerosis
prostate cancer
other cancer
hypertension (high blood pressure)
an alcohol problem
schizophrenia
chronic bronchitis
a stroke
depression or 'nerves'
other (please describe)
C12 o

Has your natural father and/or father figure had any of the following: other problem (please describe)

(If you only had a natural father, answer only under 'natural father')

Other
C13 a

Would you say that your father (or father figure) was disabled in any way?

1
Yes
2
No
7
No father figure
If yes,
qc_C13_a == 1
C13 b

please describe:

Generic text
C14 a

Would you say that any problems in your father's (or father figure's) physical or mental health affected you in any way?

4
he had no problems
1
yes, major effect
2
yes, minor effect
3
he had some problems, but they did not affect my upbringing
7
no such person
If yes,
qc_C14_a == 1 || qc_C14_a == 2
C14 b

please describe:

Generic text
C15 a(i)

Before you were 17 did a parent or person who cared for you die? mother

1
Yes
2
No
9
Don't know
C15 a(ii)

Before you were 17 did a parent or person who cared for you die? father

1
Yes
2
No
9
Don't know
C15 a(iii)

Before you were 17 did a parent or person who cared for you die? mother figure

1
Yes
2
No
9
Don't know
C15 a(iv)

Before you were 17 did a parent or person who cared for you die? father figure

1
Yes
2
No
9
Don't know
C15 a(v)

Before you were 17 did a parent or person who cared for you die? other (please describe)

1
Yes
2
No
9
Don't know
If yes,
qc_C15_a_i == 1 || qc_C15_a_ii == 1 || qc_C15_a_iii == 1 || qc_C15_a_iv == 1 || qc_C15_a_v == 1
C15 b(i)

what age were you: mother died when I was: ... years old

Age
C15 b(ii)

what age were you: father died when I was: ... years old

Age
C15 b(iii)

what age were you: mother figure died when I was: ... years old

Age
C15 b(iv)

what age were you: father figure died when I was: ... years old

Age
C15 b(v)

what age were you: other figure died when I was: ... years old

Age
C15 c(i)

If either parent died, who cared for you after their death(s)? other parent

1
Yes
2
No
C15 c(ii)

If either parent died, who cared for you after their death(s)? relative

1
Yes
2
No
C15 c(iii)

If either parent died, who cared for you after their death(s)? foster parents

1
Yes
2
No
C15 c(iv)

If either parent died, who cared for you after their death(s)? adopted parent

1
Yes
2
No
C15 c(v)

If either parent died, who cared for you after their death(s)? other (please describe)

1
Yes
2
No
Other
We would like to know how you and your mother got on when you were a child. This will probably have varied over your childhood and in different situations but we would like a general impression. Please tick the box to indicate how you mostly remember your mother in your first 16 years.
Mother (or person that took the place of your mother)
C16 a

My mother - Spoke to me with a warm and friendly voice

1
Never
2
Sometimes
3
Usually
C16 b

My mother - Helped me as much as I needed

1
Never
2
Sometimes
3
Usually
C16 c

My mother - Let me do those things I liked doing

1
Never
2
Sometimes
3
Usually
C16 d

My mother - Seemed emotionally cold to me

1
Never
2
Sometimes
3
Usually
C16 e

My mother - Appeared to understand my problems and worries

1
Never
2
Sometimes
3
Usually
C16 f

My mother - Was affectionate to me

1
Never
2
Sometimes
3
Usually
C16 g

My mother - Tried to control what I did

1
Never
2
Sometimes
3
Usually
C16 h

My mother - Invaded my privacy

1
Never
2
Sometimes
3
Usually
C16 i

My mother - Let me decide things for myself

1
Never
2
Sometimes
3
Usually
C16 j

My mother - Made me feel I wasn't wanted

1
Never
2
Sometimes
3
Usually
C16 k

My mother - Talked things over with me

1
Never
2
Sometimes
3
Usually
C16 l

My mother - Gave me the freedom I wanted

1
Never
2
Sometimes
3
Usually
C16 m

My mother - Praised me

1
Never
2
Sometimes
3
Usually
C16 n

My mother - Enjoyed talking things over with me

1
Yes
2
No
C16 o

My mother - Frequently smiled at me

1
Yes
2
No
C16 p

My mother - Tended to baby me

1
Yes
2
No
C16 q

My mother - Seemed to understand what I needed or wanted

1
Yes
2
No
C16 r

My mother - Could make me feel better when I was upset

1
Yes
2
No
C16 s

My mother - Felt I could not look after myself unless she was around

1
Yes
2
No
C16 t

My mother - Let me go out as often as I wanted

1
Yes
2
No
C16 u

My mother - Was overprotective of me

1
Yes
2
No
C16 v

My mother - Let me dress in any way I pleased

1
Yes
2
No
C17 a

Was your parent's behaviour stable and predictable to you as a child? mother

1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
C17 b

Was your parent's behaviour stable and predictable to you as a child? father

1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
C17 c

Was your parent's behaviour stable and predictable to you as a child? mother figure

1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
C17 d

Was your parent's behaviour stable and predictable to you as a child? father figure

1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
Please indicate for each age range:
C18 i

Looking back would you call your childhood happy? 0-5 years

1
Yes very happy
2
Yes moderately happy
3
Not really happy
4
No quite unhappy
5
No very unhappy
9
Can't remember
C18 ii

Looking back would you call your childhood happy? 6-11 years

1
Yes very happy
2
Yes moderately happy
3
Not really happy
4
No quite unhappy
5
No very unhappy
9
Can't remember
C18 iii

Looking back would you call your childhood happy? 12-15 years

1
Yes very happy
2
Yes moderately happy
3
Not really happy
4
No quite unhappy
5
No very unhappy
9
Can't remember
C19

Are there any comments you would like to add?

Long text
DIARY PAGE - CHILDHOOD HISTORY
C20
Below we ask you to give a summary of your childhood. Please write down the place you lived, the main person or people who looked after you (e.g. mother, father, aunt) and if any major event (e.g. a death, divorce, more serious accident) happened.
Where were you (Town, country) Who was the main person/people looking after you Any major event
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
Under 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
SECTION D: YOUR FAMILY AND FRIENDS
D1

How many of your relatives and your partner's relatives do you see at least twice a year?

1
None
2
1
3
2-4
4
more than 4
D2

About how many friends do you have ?

1
None
2
1
3
2-4
4
more than 4
D3

Overall, would you say you belong to a close circle of friends ?

1
Yes
2
No
D4

How many people are there that you can talk to about personal problems?

1
None
2
1
3
2-4
4
more than 4
D5

How many people talk to you about their personal problems or their private feelings?

1
None
2
1
3
2-4
4
more than 4
D6

If you have to make an important decision, how many people are there with whom you can discuss it?

1
None
2
1
3
2-4
4
more than 4
D7

How many people are there among your family and friends from whom you could borrow £100 if you needed to?

1
None
2
1
3
2-4
4
more than 4
D8

How many of your family and friends would help you in times of trouble?

1
None
2
1
3
2-4
4
more than 4
D9

During the last month, how many times did you get together with one or more friends?

1
None
2
1
3
2-4
4
more than 4
D10

During the last month, how many times did you get together with one or more of your relatives or your partner's relatives?

1
None
2
1
3
2-4
4
more than 4
The following statements are about the help and support you have.
D11

I have no one to share my feelings with

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D12

My partner provides the emotional support I need

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D13

There were other pregnant women with whom I was able to share my experiences

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D14

I believe in moments of difficulty my neighbours would help me

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D15

I'm worried that my partner might leave me

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D16

There was always someone with whom I could share my happiness and excitement about my pregnancy

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D17

If I feel tired I can rely on my partner to take over

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D18

If I was in financial difficulty I know my family would help if they could

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D19

If I was in financial difficulty I know my friends would help if they could

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D20

If all else fails I know the state will support and assist me

1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D21

Do you believe in God or in some divine power?

1
yes
2
am not sure
3
no, not at all
D22

Do you feel that God (or some divine power) has helped you at any time?

1
Yes
2
Not sure
3
No
D23

Would you appeal to God for help if you were in trouble?

1
Yes
2
Not sure
3
No
D24 a

What sort of religious faith would you say you had?

(tick one only)

1
Church of England
2
Roman Catholic
3
Jehovah's Witness
4
Christian Science
5
Mormon
6
Other Christian (please describe)
7
Jewish
8
Buddhist
9
Sikh
10
Hindu
11
Muslim
12
Rastafarian
0
None
13
Other (please describe)
Other
D24 b

How long have you had this particular faith?

1
all my life
2
more than 5 years
3
3-5 years
4
1-2 years
5
less than a year
D25

Do you go to a place of worship?

1
yes, at least once a week
2
yes, at least once a month
3
yes, at least once a year
4
not at all
D26 a

Do you obtain help and support from leaders or other members of religious groups? Leaders of your religious group (e.g. priests, rabbis, imams)

1
Yes
2
No
D26 b

Do you obtain help and support from leaders or other members of religious groups? Other members of your religious group

1
Yes
2
No
D26 c

Do you obtain help and support from leaders or other members of religious groups? Members of other religious group (please describe)

1
Yes
2
No
Generic text
SECTION E: YOUR OUTLOOK ON LIFE
E1

Did getting good marks at school mean a great deal to you?

1
Yes
2
No
E2

Are you often blamed for things that just aren't your fault?

1
Yes
2
No
E3

Do you feel that most of the time it doesn't pay to try hard because things never turn out right anyway?

1
Yes
2
No
E4

Do you feel that if things start out well in the morning that it's going to be a good day no matter what you do?

1
Yes
2
No
E5

Do you believe that whether or not people like you depends on how you act?

1
Yes
2
No
E6

Do you believe that when bad things are going to happen they are just going to happen no matter what you try to do to stop them?

1
Yes
2
No
E7

Do you feel that when good things happen they happen because of hard work?

1
Yes
2
No
E8

Do you feel that when someone doesn't like you there's little you can do about it?

1
Yes
2
No
E9

Did you usually feel that it was almost useless to try in school because most other children were cleverer than you?

1
Yes
2
No
E10

Are you the kind of person who believes that planning ahead makes things turn out better?

1
Yes
2
No
E11

Most of the time, do you feel that you have little to say about what your family decides to do?

1
Yes
2
No
E12

Do you think it's better to be clever than to be lucky?

1
Yes
2
No
SECTION F
F1

Please put the date of completing this questionnaire:

Generic date
F2

Please give your date of birth:

Generic date
F i

Space for any comments you might like to make:

Long text
VERY MANY THANKS FOR ALL YOUR HELP
When completed, put in the envelope provided and either bring to the clinic or post to:
Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health, 24 Tyndall Avenue, Bristol. BS8 1BR.
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice, please feel free to contact our special help line (Bristol 256260 during office hours). Alternatively your General Practitioner should be able to advise you.
End

alspac_12weeks

s_intro_i
ABOUT YOURSELF
s_intro_ii
This questionnaire asks about your health, your partner, your home, your childhood and your beliefs and attitudes. Your answers will help us to understand how mothers' own health and background might affect their pregnancies.
s_info_iii
All the answers you give are confidential. Your name and address will not be on the questionnaire.
s_intro_iv
We would be grateful if you would help us by answering as many of these questions as possible but if there is any question you do not want to answer that is fine. Just leave it blank.
s_intro_v
THANK YOU VERY MUCH FOR YOUR HELP

SECTION A: YOUR MEDICAL HISTORY

A1 a
How old were you when your periods first started?
Age
77
have not had periods
99
do not remember
A1 b
In the year before your study pregnancy would you say your periods were regular?
1
yes
2
no, not very regular
7
no periods at all
A1 c
how many days were there from the start of one period to the start of the next one ? ... days
Days
If regular,
A2 a
Have you ever used a contraceptive pill?
1
Yes
2
No
s_qA2_a
If no, go to A3.a, on page 4.
A2 b
how old were you when you first used one? ... years
Age
If yes,
A2 c
how many years altogether did you take a contraceptive pill?
1
under 1 year
2
1-2 years
3
3-4 years
4
5 years or more
If yes,
A2 d
Is it possible that you might have taken the pill when you were actually pregnant this last time?
1
Yes
2
No
If yes,
A3 a
Have you ever gone to a doctor because you thought you were infertile?
1
Yes
2
No
s_qA3_a
If no, go to A4.a
A3 b
what treatment was given?
Generic text
If yes,
A3 c(i)
Did you use any treatments to help you conceive this last pregnancy?
1
Yes
2
No
If yes,
A3 c(ii)
which one?
Generic text
If yes,
If yes,
A4 a
What was your weight before you started this last pregnancy? (please indicate whether stones, pounds or kilos)
Generic text
A4 b
Are you certain of your weight before you started this pregnancy?
1
Yes
2
No
A4 c(i)
Before you became pregnant this last time, what was your size in:- hips ... ins.
Inches
A4 c(ii)
Before you became pregnant this last time, what was your size in:- waist ... ins.
Inches
A4 c(iii)
Before you became pregnant this last time, what was your size in:- bust ... ins.
Inches
s_qA4_c
(if you don't know write NK)
A4 d
How tall are you ? (Please indicate whether feet, inches or metres)
Generic text
A4 d(i)
Are you certain of this?
1
Yes
2
No
A5 a
Have you ever had diabetes?
1
Yes
2
No
s_qA5_a
If No, go to A5.b, on page 6.
A5 a(i)
have you only had it when you were pregnant?
1
Yes
2
No
If yes,
A5 a(ii)
how is/was it treated?
1
insulin injections
2
other drugs
3
diet only
If yes,
A5 a(iii)
how old were you when you first developed it? ... years
Age
If yes,
A5 b
Have you ever had hypertension (high blood pressure)?
1
Yes
2
No
A5 b(i)
Have you had it only when pregnant?
1
Yes
2
No
If yes,
A5 b(ii)
How old were you when you first developed it? ... years
Age
If yes,
A5 b(iii)
How is it treated?
Generic text
If yes,
A6 a
Have you ever had any of the following infections: measles
1
Yes
2
No never
9
Don't know
A6 b
Have you ever had any of the following infections: mumps
1
Yes
2
No never
9
Don't know
A6 c
Have you ever had any of the following infections: chicken pox
1
Yes
2
No never
9
Don't know
A6 d
Have you ever had any of the following infections: whooping cough
1
Yes
2
No never
9
Don't know
A6 e
Have you ever had any of the following infections: cold sores
1
Yes
2
No never
9
Don't know
A6 f
Have you ever had any of the following infections: meningitis
1
Yes
2
No never
9
Don't know
A6 g
Have you ever had any of the following infections: genital herpes
1
Yes
2
No never
9
Don't know
A6 h
Have you ever had any of the following infections: syphilis
1
Yes
2
No never
9
Don't know
A6 i
Have you ever had any of the following infections: gonorrhea
1
Yes
2
No never
9
Don't know
A6 j
Have you ever had any of the following infections: urinary infection, cystitis, pyelitis
1
Yes
2
No never
9
Don't know
A7 a
Have you ever had any of the following operations: tonsils out
1
Yes
2
No
A7 b
Have you ever had any of the following operations: adenoids out
1
Yes
2
No
A7 c
Have you ever had any of the following operations: hernia repair
1
Yes
2
No
A7 d
Have you ever had any of the following operations: appendix out
1
Yes
2
No
A7 e
Have you ever had any of the following operations: gall bladder out
1
Yes
2
No
A7 f
Have you ever had any of the following operations: D and C (a scrape)
1
Yes
2
No
A7 g
Have you ever had any of the following operations: pyloric stenosis operation
1
Yes
2
No
A7 h
Have you ever had any of the following operations: squint repaired
1
Yes
2
No
A7 i
Have you ever had any of the following operations: plastic surgery
1
Yes
2
No
A7 j
Have you ever had any of the following operations: grommets in your ears
1
Yes
2
No
A7 k
Have you ever had any of the following operations: other type of operation (please tick and describe)
1
Yes
2
No
Other
A8 a-q

Have any of the following ever happened?

- Age this first happened

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age

1 - Yes and stayed in hospital

2 - Yes saw doctor, did not stay in hospital

3 - Yes treated at home only

4 - No never happened

Age
You were badly burnt
You were badly scalded
You took a lot of pills or medicine
You broke an arm or hand
You broke a leg or foot
You nearly drowned
You were in a road traffic accident
You were sexually assaulted
You were injured playing sports or games
You had an accident while on a bicycle
You were injured in a fight
Your parents hurt you
You were hurt by someone else
Your head was hit
You were badly cut
You had a bad fall
You had another type of accident or injury (please describe)
A8 q
Have any of the following ever happened? You had another type of accident or injury (please describe)
Other
A9 a
Have you ever had any of the following problems: hay fever
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 b
Have you ever had any of the following problems: indigestion
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 c
Have you ever had any of the following problems: bulimia
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 d
Have you ever had any of the following problems: asthma
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 e
Have you ever had any of the following problems: eczema
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 f
Have you ever had any of the following problems: epilepsy
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 g
Have you ever had any of the following problems: convulsions with a fever
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 h
Have you ever had any of the following problems: migraine
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 i
Have you ever had any of the following problems: back pain/slipped disc
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 j
Have you ever had any of the following problems: kidney disease
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 k
Have you ever had any of the following problems: varicose veins
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 l
Have you ever had any of the following problems: haemorrhoids/piles
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 m
Have you ever had any of the following problems: rheumatism
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 n
Have you ever had any of the following problems: arthritis
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 o
Have you ever had any of the following problems: psoriasis
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 p
Have you ever had any of the following problems: stomach ulcer
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 q
Have you ever had any of the following problems: pelvic inflammatory disease (PID)
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 r
Have you ever had any of the following problems: drug addiction
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 s
Have you ever had any of the following problems: alcoholism
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 t
Have you ever had any of the following problems: schizophrenia
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 u
Have you ever had any of the following problems: anorexia nervosa
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 v
Have you ever had any of the following problems: severe depression
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 w
Have you ever had any of the following problems: other psychiatric problem
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
A9 x
Have you ever had any of the following problems: other problem (please tick & describe)
1
Yes had it recently
2
Yes in past, not now
3
No never
9
Don't know
Other
A10 a
Are there any problems for which you have regular treatment or medicine?
1
Yes
2
No
s_qA10_a
If No, go to A11, on page 11.
A10 b

please describe the problem and regular treatment or medicine:

Problem Treatment or medicine
Generic textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric text
1
2
3
4
If yes,
A11 a
Would you say that you were allergic to anything?
1
Yes
2
No
s_qA11_a
If No, go to A12.
A11 b(i-v)

is it to:

-

1 - Yes

2 - No

9 - Don't know
cat
pollen
dust
insect bites or stings
If yes,
A11 b(v)
is it to: something else (please describe)
1
Yes
2
No
9
Don't know
Other
If yes,
A12 a-i

Have you had any of the following in the past two years:

-

1 - Yes, often

2 - Yes, sometimes

3 - No, not at all
attacks of wheezing with whistling on the chest
a dry itchy rash
a blotchy blistery rash (hives)
sneezing attacks
runny nose
watery eyes
attacks of breathlessness
cough often during the night
cough often when you wake in the morning
A13 a
Do you know how much you weighed when you were born?
1
Yes
2
No
A13 aa
give weight:
Generic text
If yes,
A13 b
Were you born:
1
more than 3 weeks before your expected date
2
at around the date expected
3
more than 3 weeks late
9
don't know
A13 c(i)
Were you born with any of the following: hare lip
1
Yes
2
No
A13 c(ii)
Were you born with any of the following: birthmark
1
Yes
2
No
A13 c(iii)
Were you born with any of the following: cleft palate
1
Yes
2
No
A13 c(iv)
Were you born with any of the following: heart disease
1
Yes
2
No
A13 c(v)
Were you born with any of the following: malformed feet
1
Yes
2
No
A13 c(vi)
Were you born with any of the following: unusual shaped head
1
Yes
2
No
A13 c(vii)
Were you born with any of the following: spina bifida
1
Yes
2
No
A13 c(viii)
Were you born with any of the following: extra finger
1
Yes
2
No
A13 c(ix)
Were you born with any of the following: extra toe
1
Yes
2
No
A13 c(x)
Were you born with any of the following: funny shaped fingers or hands
1
Yes
2
No
A13 c(xi)
Were you born with any of the following: missing part of body
1
Yes
2
No
A13 c(xii)
Were you born with any of the following: other (please describe all such problems below)
1
Yes
2
No
Other
A13 d(i)
Were you born in a hospital?
1
Yes
2
No
9
Don't know
A13 d(ii)
Name of hospital
Generic text
If yes, please give:
A13 e(i)
Where were your parents living at the time you were born? Town:
Generic text
A13 e(ii)
Where were your parents living at the time you were born? County:
Generic text
A13 e(iii)
Where were your parents living at the time you were born? Country:
Generic text

Your hearing

A14 a(i)
How would you rate your hearing in each ear? Left ear
1
always very good
2
occasional problems (eg.infections or glue ear)
3
there are some sounds I can not hear
4
never very good
5
I cannot hear much at all
A14 a(ii)
How would you rate your hearing in each ear? Right ear
1
always very good
2
occasional problems (eg.infections or glue ear)
3
there are some sounds I can not hear
4
never very good
5
I cannot hear much at all

Your eyesight

A15 a(i)
How would you rate your sight without glasses? Left eye
1
always very good
2
I can't see clearly at a distance
3
I can't see clearly close up
4
I can't see much at all
A15 a(ii)
How would you rate your sight without glasses? Right eye
1
always very good
2
I can't see clearly at a distance
3
I can't see clearly close up
4
I can't see much at all
A15 b
Are you colour blind?
1
Yes
2
No
9
Don't know
A16 a
When you were a child did you ever go to any of the following? physiotherapist
1
Yes
2
No
9
Not known
A16 a(i)
what for:
Generic text
If yes,
A16 b
When you were a child did you ever go to any of the following? child guidance or child psychiatrist
1
Yes
2
No
9
Not known
A16 b(i)
what for:
Generic text
If yes,
A16 c
When you were a child did you ever go to any of the following? speech therapist
1
Yes
2
No
9
Not known
A16 c(i)
what for:
Generic text
If yes,
A16 d
When you were a child did you ever go to any of the following? special schooling
1
Yes
2
No
9
Not known
A16 d(i)
what for:
Generic text
If yes,
A17 a-d

Did you or any of your family have a problem of bedwetting or daytime wetting? (when older than 5 years)

-

1 - Yes, bed-wetting

2 - Yes, daytime wetting

4 - No, not at all

9 - Don't know
you
brother or sister
mother
father
A18 a
Have you had a wetting accident yourself in the past year, either during the night or day?
1
Yes
2
No
A18 b(i)
Could you please indicate how many nights or days this has occurred within the past month: during the night:
Days in month
If yes,
A18 b(ii)
Could you please indicate how many nights or days this has occurred within the past month: during the day:
Days in month
If yes,
A19 a
Have you ever been a blood donor?
1
Yes
2
No
A19 b
If you were found to have a rare blood type during this pregnancy would you be willing to give blood?
1
Yes
2
No
A20 a-l

Many people have X-rays, barium meals and other procedures. Please indicate whether you have ever had any of the following types of X-ray.

During this last pregnancy In the year before this last pregnancy Any other time during your life

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No
X-ray to: arm or hand
X-ray to: chest
X-ray to: leg or foot
X-ray to: dental
X-ray to: head or neck
X-ray to: back
X-ray to: barium meal
X-ray to: barium enema
X-ray to: IVP (intravenous pyelogram}
X-ray to: hips or pelvis
X-ray to: stomach or abdomen
X-ray to: any other (please describe)
A20 l
Many people have X-rays, barium meals and other procedures.Please indicate whether you have ever had any of the following types of X-ray. any other (please describe)
Other

SECTION B: YOUR PARTNER

s_section_B_i
The following questions are about how you and your partner behave towards each other. Please indicate how often you and your partner behave in the ways listed.
s_section_B_ii
* If you do not have a partner at the moment tick 'Not applicable'.
B1
Is your partner affectionate toward you?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B2
Does your partner get angry with you?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B3
Does your partner listen to you when you want to talk about your feelings?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B4
Do you have arguments with your partner?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B5
Does your partner talk to you about his problems and feelings?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B6
Do you get angry with your partner?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B7
Do you enjoy the company of your partner?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B8
Does your partner show his approval of you?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B9
Do you behave affectionately toward your partner?
1
Almost always
2
Often
3
Sometimes
4
Rarely
5
Never
7
Not applicable
B10
How old is your partner? ... years
Age

SECTION C: YOU AND YOUR PARENTS

C1 a
Were you legally adopted?
1
Yes
2
No
C1 b
what age were you?
Generic text
If yes,
C2
Were you ever "in care" of either a local authority or voluntary agency e.g. Barnados?
1
Yes
2
No
9
Unsure
C3 a
Did your parents divorce or separate before your 18th birthday?
1
Yes
2
No
s_qC3_a
If No, go to C4, on page 19.
C3 b
what age were you?
Generic text
If yes,
C3 c
who did you mainly live with after this?
1
mother
2
father
3
sometimes mother, sometimes father
4
someone else (please say who)
Other
If yes,
C4 i-iv

Did you ever live away from home with any of the following (other than for holidays/or short visits) before you were 18 years old?

-

1 - Yes

2 - No
grandparents
other relatives
friends
foster parents
C4 v
Did you ever live away from home with any of the following (other than for holidays/or short visits) before you were 18 years old? other (please describe)
1
Yes
2
No
Other
C5 i-v

Did you ever stay away from home in any of the following places before you were 18 years old?

-

1 - No

2 - Yes for less than a week

3 - Yes for 1 week - 1 month

4 - Yes for 1 - 6 months

5 - Yes over 6 months
hospital
boarding school
children's home
hostel
in custody (detention centre, remand home, borstal etc)
C5 vi
Did you ever stay away from home in any of the following places before you were 18 years old? other please describe)
1
No
2
Yes for less than a week
3
Yes for 1 week - 1 month
4
Yes for 1 - 6 months
5
Yes over 6 months
Other
C6 a
Did you leave home before your 18th birthday?
1
Yes
2
No
s_qC6_a
If no, go to C7, on page 20.
C6 b
At that time where did you first live?
1
college residence
2
hostel
3
bedsit
4
shared flat or house
5
other (please describe)
Other
If yes,
C7 a-n

At each of the time periods given, during your childhood, who of the following lived in your home (other than for holidays or short visits)?

0-5 years 6-11 years 12-16 years

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No

1 - Yes

0 - No
mother
father
brother(s)
sister(s)
step-mother
step-father
step-brother(s)
step-sister(s)
mother's partner
father's partner
grandmother
grandfather
family friend
other (please describe)
C7 n
At each of the time periods given, during your childhood, who of the following lived in your home (other than for holidays or short visits)? other (please describe)
Other
C8 a
Who would you say brought you up? mother
1
Yes
2
No
3
Did not have
C8 b
Who would you say brought you up? father
1
Yes
2
No
3
Did not have
C8 c
Who would you say brought you up? brother(s)
1
Yes
2
No
3
Did not have
C8 d
Who would you say brought you up? sister(s)
1
Yes
2
No
3
Did not have
C8 e
Who would you say brought you up? step-mother
1
Yes
2
No
3
Did not have
C8 f
Who would you say brought you up? step-father
1
Yes
2
No
3
Did not have
C8 g
Who would you say brought you up? step-brother(s)
1
Yes
2
No
3
Did not have
C8 h
Who would you say brought you up? step-sister(s)
1
Yes
2
No
3
Did not have
C8 i
Who would you say brought you up? mother's partner
1
Yes
2
No
3
Did not have
C8 j
Who would you say brought you up? father's partner
1
Yes
2
No
3
Did not have
C8 k
Who would you say brought you up? grandmother
1
Yes
2
No
3
Did not have
C8 l
Who would you say brought you up? grandfather
1
Yes
2
No
3
Did not have
C8 m
Who would you say brought you up? adoptive mother
1
Yes
2
No
3
Did not have
C8 n
Who would you say brought you up? adoptive father
1
Yes
2
No
3
Did not have
C8 o
Who would you say brought you up? foster mother
1
Yes
2
No
3
Did not have
C8 p
Who would you say brought you up? foster father
1
Yes
2
No
3
Did not have
C8 q
Who would you say brought you up? family friend
1
Yes
2
No
3
Did not have
C8 r
Who would you say brought you up? other (please describe)
1
Yes
2
No
3
Did not have
Other
C9 a-o

Has your natural mother and/or mother figure had any of the following:

Natural mother Mother figure

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know
diabetes treated with insulin
other diabetes
coronary heart disease
rheumatism
arthritis
multiple sclerosis
breast cancer
other cancer
hypertension (high blood pressure)
an alcohol problem
schizophrenia
chronic bronchitis
a stroke
depression or 'nerves'
other problem (please describe)
C9 o
Has your natural mother and/or mother figure had any of the following: other problem (please describe)
Other
C10 a
Would you say that your mother (or mother figure) was disabled in any way?
1
Yes
2
No
C10 b
please describe:
Generic text
If yes,
C11 a
Would you say that any problems in your mother's (or mother figure's) physical or mental health affected you in any way?
4
she had no problems
1
yes, major effect
2
yes, minor effect
3
she had some problems, but they did not affect my upbringing
C11 b
please describe:
Generic text
If yes,
C12 a-o

Has your natural father and/or father figure had any of the following:

Natural father Father figure

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know

1 - Yes

2 - No

9 - Don't know
diabetes treated with insulin
other diabetes
coronary heart disease
rheumatism
arthritis
multiple sclerosis
prostate cancer
other cancer
hypertension (high blood pressure)
an alcohol problem
schizophrenia
chronic bronchitis
a stroke
depression or 'nerves'
other (please describe)
C12 o
Has your natural father and/or father figure had any of the following: other problem (please describe)
Other
C13 a
Would you say that your father (or father figure) was disabled in any way?
1
Yes
2
No
7
No father figure
C13 b
please describe:
Generic text
If yes,
C14 a
Would you say that any problems in your father's (or father figure's) physical or mental health affected you in any way?
4
he had no problems
1
yes, major effect
2
yes, minor effect
3
he had some problems, but they did not affect my upbringing
7
no such person
C14 b
please describe:
Generic text
If yes,
C15 a(i)
Before you were 17 did a parent or person who cared for you die? mother
1
Yes
2
No
9
Don't know
C15 a(ii)
Before you were 17 did a parent or person who cared for you die? father
1
Yes
2
No
9
Don't know
C15 a(iii)
Before you were 17 did a parent or person who cared for you die? mother figure
1
Yes
2
No
9
Don't know
C15 a(iv)
Before you were 17 did a parent or person who cared for you die? father figure
1
Yes
2
No
9
Don't know
C15 a(v)
Before you were 17 did a parent or person who cared for you die? other (please describe)
1
Yes
2
No
9
Don't know
C15 b(i)
what age were you: mother died when I was: ... years old
Age
If yes,
C15 b(ii)
what age were you: father died when I was: ... years old
Age
If yes,
C15 b(iii)
what age were you: mother figure died when I was: ... years old
Age
If yes,
C15 b(iv)
what age were you: father figure died when I was: ... years old
Age
If yes,
C15 b(v)
what age were you: other figure died when I was: ... years old
Age
If yes,
C15 c(i)
If either parent died, who cared for you after their death(s)? other parent
1
Yes
2
No
If yes,
C15 c(ii)
If either parent died, who cared for you after their death(s)? relative
1
Yes
2
No
If yes,
C15 c(iii)
If either parent died, who cared for you after their death(s)? foster parents
1
Yes
2
No
If yes,
C15 c(iv)
If either parent died, who cared for you after their death(s)? adopted parent
1
Yes
2
No
If yes,
C15 c(v)
If either parent died, who cared for you after their death(s)? other (please describe)
1
Yes
2
No
Other
If yes,
s_qC16
We would like to know how you and your mother got on when you were a child. This will probably have varied over your childhood and in different situations but we would like a general impression. Please tick the box to indicate how you mostly remember your mother in your first 16 years.

Mother (or person that took the place of your mother)

C16 a
My mother - Spoke to me with a warm and friendly voice
1
Never
2
Sometimes
3
Usually
C16 b
My mother - Helped me as much as I needed
1
Never
2
Sometimes
3
Usually
C16 c
My mother - Let me do those things I liked doing
1
Never
2
Sometimes
3
Usually
C16 d
My mother - Seemed emotionally cold to me
1
Never
2
Sometimes
3
Usually
C16 e
My mother - Appeared to understand my problems and worries
1
Never
2
Sometimes
3
Usually
C16 f
My mother - Was affectionate to me
1
Never
2
Sometimes
3
Usually
C16 g
My mother - Tried to control what I did
1
Never
2
Sometimes
3
Usually
C16 h
My mother - Invaded my privacy
1
Never
2
Sometimes
3
Usually
C16 i
My mother - Let me decide things for myself
1
Never
2
Sometimes
3
Usually
C16 j
My mother - Made me feel I wasn't wanted
1
Never
2
Sometimes
3
Usually
C16 k
My mother - Talked things over with me
1
Never
2
Sometimes
3
Usually
C16 l
My mother - Gave me the freedom I wanted
1
Never
2
Sometimes
3
Usually
C16 m
My mother - Praised me
1
Never
2
Sometimes
3
Usually
C16 n
My mother - Enjoyed talking things over with me
1
Yes
2
No
C16 o
My mother - Frequently smiled at me
1
Yes
2
No
C16 p
My mother - Tended to baby me
1
Yes
2
No
C16 q
My mother - Seemed to understand what I needed or wanted
1
Yes
2
No
C16 r
My mother - Could make me feel better when I was upset
1
Yes
2
No
C16 s
My mother - Felt I could not look after myself unless she was around
1
Yes
2
No
C16 t
My mother - Let me go out as often as I wanted
1
Yes
2
No
C16 u
My mother - Was overprotective of me
1
Yes
2
No
C16 v
My mother - Let me dress in any way I pleased
1
Yes
2
No
C17 a
Was your parent's behaviour stable and predictable to you as a child? mother
1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
C17 b
Was your parent's behaviour stable and predictable to you as a child? father
1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
C17 c
Was your parent's behaviour stable and predictable to you as a child? mother figure
1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
C17 d
Was your parent's behaviour stable and predictable to you as a child? father figure
1
Always
2
Mostly
3
Rarely
4
Never
7
Not applicable
s_qC18
Please indicate for each age range:
C18 i
Looking back would you call your childhood happy? 0-5 years
1
Yes very happy
2
Yes moderately happy
3
Not really happy
4
No quite unhappy
5
No very unhappy
9
Can't remember
C18 ii
Looking back would you call your childhood happy? 6-11 years
1
Yes very happy
2
Yes moderately happy
3
Not really happy
4
No quite unhappy
5
No very unhappy
9
Can't remember
C18 iii
Looking back would you call your childhood happy? 12-15 years
1
Yes very happy
2
Yes moderately happy
3
Not really happy
4
No quite unhappy
5
No very unhappy
9
Can't remember
C19
Are there any comments you would like to add?
Long text

DIARY PAGE - CHILDHOOD HISTORY

C20

Below we ask you to give a summary of your childhood. Please write down the place you lived, the main person or people who looked after you (e.g. mother, father, aunt) and if any major event (e.g. a death, divorce, more serious accident) happened.

Where were you (Town, country) Who was the main person/people looking after you Any major event
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
Under 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years

SECTION D: YOUR FAMILY AND FRIENDS

D1
How many of your relatives and your partner's relatives do you see at least twice a year?
1
None
2
1
3
2-4
4
more than 4
D2
About how many friends do you have ?
1
None
2
1
3
2-4
4
more than 4
D3
Overall, would you say you belong to a close circle of friends ?
1
Yes
2
No
D4
How many people are there that you can talk to about personal problems?
1
None
2
1
3
2-4
4
more than 4
D5
How many people talk to you about their personal problems or their private feelings?
1
None
2
1
3
2-4
4
more than 4
D6
If you have to make an important decision, how many people are there with whom you can discuss it?
1
None
2
1
3
2-4
4
more than 4
D7
How many people are there among your family and friends from whom you could borrow £100 if you needed to?
1
None
2
1
3
2-4
4
more than 4
D8
How many of your family and friends would help you in times of trouble?
1
None
2
1
3
2-4
4
more than 4
D9
During the last month, how many times did you get together with one or more friends?
1
None
2
1
3
2-4
4
more than 4
D10
During the last month, how many times did you get together with one or more of your relatives or your partner's relatives?
1
None
2
1
3
2-4
4
more than 4
s_qD11
The following statements are about the help and support you have.
D11
I have no one to share my feelings with
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D12
My partner provides the emotional support I need
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D13
There were other pregnant women with whom I was able to share my experiences
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D14
I believe in moments of difficulty my neighbours would help me
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D15
I'm worried that my partner might leave me
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D16
There was always someone with whom I could share my happiness and excitement about my pregnancy
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D17
If I feel tired I can rely on my partner to take over
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D18
If I was in financial difficulty I know my family would help if they could
1
This is exactly how I feel
2
This is often how I feel
3
This is how I sometimes feel
4
I never feel this way
D19